tbuckley/cabot-search huggingface dataset:
AB1056 ASSESSMENT OF PULMONARY CIRCULATION WITH STRESS ECHOCARDIOGRAPHY IN ANKYLOSING SPONDYLITIS AND PSORIATIC ARTHRITIS
Authors: S. Burcsar, B. Morvai-Illes, M. Monoki, A. Varga, G. Agoston, A. Balog
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Extra-articular features are common in ankylosing spondylitis (AS) and in psoriatic arthritis PsA. Cardiac involvement are less frequent but may be severe. The anterior chest wall pain and sterno-costal arthritis can lead to reduced chest expansion, which may contribute to the progression of cardiopulmonary manifestations. We aimed to assess the response of the pulmonary circulation unit during stress in AS and PsA patients. <h3>Objectives:</h3> <h3>Methods</h3> A total of 71 patients were enrolled in the study: 28 of them had AS (age 50.8±11.8 years), 17 APs (age 52.1±13.5 years), and 26 were healthy individuals (age 54.23±9.9 years). 74,1 % of AS patient, 11,1 % of PsA patient had ankylosis at the time of assessment. To the maximally tolerated workload, all subjects underwent resting and exercise stress echocardiography on a supine bicycle ergometer. Echocardiographic measurements were taken at rest, at 50 watts workload, and at maximal exercise. <h3>Results</h3> AS patients had significantly higher pulmonary artery systolic pressure (PASP; AS: 32.6±16.8 mmHg, APs: 21.6±12.7 mmHg, p&lt;0.05) and pulmonary vascular resistance (PVR; AS: 1.3±0.4 WU, PsA: 1.1±0.3 WU, p&lt;0.05) at maximal workload, while the right ventricular-pulmonary arterial (RV-PA) coupling at peak stress was higher in APs patients (AS: 1.2±0.6 mm/mmHg, PsA: 1.8±1.1 mm/mmHg, p&lt;0.05). Comparing to the control group, AS and PsA patients had significantly higher resting PASP (control: 12.6±6.4 mmHg; AS: 22.8±7.6 mmHg, p&lt;0.001; PsA: 21.4±7.0 mmHg, p&lt;0.001), lower resting RV-PA coupling (control: 2.7±1.4 mm/mmHg; AS: 1.3±0.4, p&lt;0.001; PsA 1.3±0.4 mm/mmHg, p&lt;0.001), and higher peak PVR (control: 0.6±0.4 WU; AS: 1.3±0.4, p&lt;0.001; PsA: 1.1±0.3 WU, p&lt;0.005). One-way analysis of variance of the three groups also showed significant differences in the resting PASP (p&lt;0.001), peak PASP (p&lt;0.05), resting RV-PA coupling (p&lt;0.001), peak PVR (p&lt;0.001). At maximal workload, the AS patient had higher E/e' in ankylosing group. <h3>Conclusion</h3> Stress echocardiography is a promising, radiation-free method for assessing the subclinical cardiopulmonary changes among AS and PsA patients. The changes of PVR during stress may highlight the pulmonary complications in the subclinical stage. Higher E/e' in ankylosing group can refer to the influence of ankylosis on the left ventricular filling. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
POS1219 INCIDENCE, FEATURES AND OUTCOME OF DISEASE RELAPSE AFTER COVID-19 VACCINATION IN PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES
Authors: T. G. Béldi, M. Nagy-Vincze, K. Szabó, A. Vincze, B. Miltényi-Szabó, Z. Varga, J. Varga, Z. Griger
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The approved COVID-19 vaccines showed clear safety and efficacy in reduction of severe SARS-CoV-2 disease. Patients with idiopathic inflammatory myopathies (IIM) were not well represented in these vaccine trials and there are limited data in the literature about development of confirmed disease flare after COVID-19 vaccination. <h3>Objectives</h3> To evaluate frequency, features and outcome of disease relapses in patients with IIM following SARS–CoV-2 vaccination. <h3>Methods</h3> A cohort of 176 IIM patients (mean age:57.6 years, 117 females, 59 males, 106 PM, 70 DM) were interviewed after the 3rd wave of COVID-19 pandemic and prospectively followed. Relapses were determined using the IMACS disease state criteria, outcome of the flares with myositis response criteria, calculating the total improvement score (TIS). <h3>Results</h3> A total of 146 (82.9%) patients received vaccination and 17/146 (11.6%) patients had relapse within 3 months and 13/146 (8.9%) patients within one month. The relapse rate of unvaccinated patients (1/30; 3.3%) was not significantly different (p&gt;0.1). No fatal flare has been observed. Three months after the post-vaccination relapses, 70.6% of the patients (12/17) achieved improvement of disease activity (average TIS score:30±15.81; 7 minor, 5 moderate and 0 major improvement). Six months after flares improvement was detected in 14/16 (87.5%) of relapsed patients (average TIS score: 43±20.17; 3 minimal, 7 moderate and 4 major). Forward stepwise logistic regression analysis revealed that the active state of myositis at time of injection (p&lt;0.0001; OR: 31.2 CI: 9.0 – 108) and the application of BNT162b2 vaccination (p=0.026; OR: 4.06 CI: 1.1 – 14.7) were significantly associated with the occurrence of relapse. <h3>Conclusion</h3> Minority of the vaccinated IIM patients had confirmed disease flare after COVID-19 vaccination and majority of the relapses improved after individualized treatment. Active disease state at the time of vaccination probably contributes to the increased risk of post vaccination myositis flare. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0037 GENETIC EVIDENCE REVEALS A CAUSAL ROLE OF WHITE BLOOD CELL COUNT IN OSTEOARTHRITIS
Authors: Q. Wang, X. Ma, Y. Niu, Q. Yu, P. F. He, X. Li, S. X. Zhang
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Osteoarthritis (OA) is increasingly recognized as a disease with a significant inflammatory component[1]. Signs of inflammation such as synovitis can be identified in OA patients using magnetic resonance imaging (MRI) and ultrasonographic imaging. The white blood cell count in synovial tissue has been considered useful in the assessment and diagnosis of arthritis. However, the causal relationship between the white blood cell count and OA has yet to be well. <h3>Objectives</h3> To investigate associations between white blood cell count and OA. <h3>Methods</h3> Mendelian randomized analysis (MR) was performed using white blood cell count as exposure data and OA as outcome data. This study included 173,480 individuals of European ancestry for exposure traits from three extensive UK studies[2]. The random effects inverse variance weighting (IVW) method was used for the primary analysis, and the weighted median and MR-Egger methods were supplemented for analysis. Then, we performed Cochran's Q test, MR pleiotropy residual sum and outlier (MR-PRESSO), to test for heterogeneity and horizontal multiplicity. The sensitivity analysis was also performed to verify the robustness of the primary results of the MR analysis. <h3>Results</h3> IVW method showed that knee or hip (OR=0.942, 95% CI:0.895-0.990, P =0.019), knee (OR=0.944, 95% CI:0.886-1.007, P=0.041) and hip (OR=0.929, 95% CI:0.868-0.995, P=0.035)had a protective effect on white blood cell count. After removing the confounding factors, we identified a significant causal association between white blood cell count and OA by IVW using residual single nucleotide polymorphisms (157 remaining in knee, 159 remaining in hip, and 159 remaining in knee or hip). P values of IVW were less than 0.05, indicating a significant causal relationship. Further sensitivity analyses validated the robustness of the MR results.(Figure 1) <h3>Conclusion</h3> There was a significant causal relationship between white blood cell count and OA. This is meaningful for the prevention and treatment of OA in the future. <h3>References</h3> [1]McCabe PS, Parkes MJ, Maricar N, Hutchinson CE, Freemont A, O'Neill TW, et al. Brief Report: Synovial Fluid White Blood Cell Count in Knee Osteoarthritis: Association With Structural Findings and Treatment Response. Arthritis &amp; rheumatology (Hoboken, NJ). 2017;69(1):103-7. [2]Astle WJ, Elding H, Jiang T, Allen D, Ruklisa D, Mann AL, et al. The Allelic Landscape of Human Blood Cell Trait Variation and Links to Common Complex Disease. Cell. 2016;167(5):1415-29.e19. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0009 UNTREATED EARLY RHEUMATOID ARTHRITIS PATIENTS HAVE AN ABNORMAL DISTRIBUTION OF B AND FOLLICULAR T HELPER CELL SUBSETS IN PERIPHERAL BLOOD
Authors: C. Tomé, R. L. Teixeira, S. C. Barreira, P. Martins, J. Polido-Pereira, A. Valido, M. J. Saavedra, C. Ponte, R. Barros, V. C. Romão, L. Graca, J. E. Fonseca, R. A. Moura
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Disturbances in B cell immune responses have been implicated in rheumatoid arthritis (RA) pathogenesis since the first weeks of RA development. However, the mechanisms responsible for these immune alterations remain unclear. Follicular helper T (Tfh) cells are crucial for B cell maturation, activation and class-switching as well as for germinal center (GC) formation, whereas follicular regulatory T (Tfr) cells can modulate the GC reaction by suppressing Tfh and B cells. <h3>Objectives</h3> The main goal of this study was to analyze the frequency and phenotype of B, Tfh and Tfr cells in peripheral blood of untreated early RA patients when compared to patients with early non-RA polyarthritis, established RA and healthy controls. <h3>Methods</h3> Blood samples were collected from 35 untreated early polyarthritis patients (&lt;1 year of disease duration), who later evolved into RA (early RA, ERA) (n=23) or other diagnoses (early non-RA, ENRA) (n=12); established seropositive RA patients (n=62) treated with methotrexate and a group of age- and sex-matched healthy controls (n=20). Peripheral blood mononuclear cells were isolated and the frequency and phenotype of B, Tfh and Tfr cells were evaluated by flow cytometry. <h3>Results</h3> ERA patients had similar frequencies of B, Tfh and Tfr cells in circulation when compared to ENRA, established RA and controls. Nevertheless, ERA patients had significantly lower frequencies of pre-switch memory B cells (IgD+CD27+) and higher levels of double negative B cells (IgD-CD27-), CD21lowCD38low B cells and plasmablasts (IgD-CD38++) in peripheral blood when compared to controls. Furthermore, the frequencies of PD-1+ICOS+ Tfh cells and Th2-like Tfh cells were significantly increased in ERA patients when compared to controls. Changes in B, Tfh and Tfr cells phenotype were also observed in ERA patients when compared to controls, particularly an increase of the expression levels of activation markers (CD28, CD69, CD86 and HLA-DR). <h3>Conclusion</h3> ERA patients have alterations in B and Tfh cell subpopulations, but not in Tfr cells, in circulation when compared to healthy controls. Our results suggest a pre-activation state of B and Tfh cells since early RA development, which supports a role of these cells in disease physiopathology. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0054 BIOMARKERS OF BONE ACTIVITY IN RHEUMATOID ARTHRITIS SYNOVIAL TISSUE AND THEIR RELATIONSHIP WITH CLINICAL OUTCOME
Authors: B. Le, A. Small, K. Lowe, H. Weedon, S. Proudman, M. Smith, J. Walker, M. Wechalekar
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic autoimmune disease which can involve bone joint degradation. The Wnt-β/catenin signalling pathway is a major promoter of bone formation. Following triple-DMARD treatment of rheumatoid arthritis patients, systemic levels of sclerostin are increased, correlating with improved patient response. This lies in contrast with the established role of sclerostin as a Wnt-antagonist, which would inhibit bone formation and suggests a protective role for sclerostin against bone loss. However, it is not known if this change is reflected in synovial tissues, the site of inflammation in RA. <h3>Objectives</h3> This study characterised the expression of sclerostin and other biomarkers associated with bone metabolism in synovial tissue biopsy samples in relation to patient erosive status (Sharpe/van der Heijde method), the presence of TNF (as judged by immunohistochemistry (IHC)) and response to treatment (European League Against Rheumatism (EULAR) scores). <h3>Methods</h3> Arthroscopic synovial tissue biopsies from patients with early rheumatoid arthritis, before and after treatment with adalimumab or abatacept were examined for sclerostin and LRP5/6, by immunohistochemistry (IHC), immunofluorescence staining, flow cytometry and bulk RNA sequencing, in addition to other biomarkers associated with bone metabolism. Total RNA libraries were produced using the Tecan Universal Plus Total RNA library preparation kit. Samples were sequenced on 3 x S4 lanes of the NovaSeq using paired end 100 bp reads (Illumina). <h3>Results</h3> No significant changes were observed for both sclerostin and LRP5/6 between erosive and non-erosive patients and at 6-month post-treatment. However, the expression of sclerostin in IHC stains of synovial tissues was significantly increased in TNF-non-dominant patients compared to those who were TNF-dominant. Sclerostin and LRP5/6 expression was localised to different cell populations in synovial tissue. <h3>Conclusion</h3> Bulk assessment of sclerostin and other bone biomarkers within synovial tissue does not currently demonstrate a relationship with clinical outcome. However, further assessment of sclerostin and other biomarkers of bone activity in specific cell types, within synovial tissue, can provide further insights into the role of sclerostin and Wnt pathway molecules in bone homeostasis in the context of RA and may provide biomarkers of erosive disease progression. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0684 RETROSPECTIVE STUDY ON SENSITIVITY AND SPECIFICITY OF VARIOUS CLASSIFICATION CRITERIA IN EARLY DIAGNOSIS OF SYSTEMIC LUPUS ERYTHEMATOSUS AND LINK TO DISEASE OUTCOMES
Authors: M. S. Mohamed Said, S. Chu Ee, R. Mustafa
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic lupus erythematosus (SLE) is a multisystem inflammatory disease with heterogeneous clinical manifestations, making the diagnosis of disease challenging. To date, study on comparison of sensitivity and specificity of various SLE classification criteria among multiracial Malaysians is limited. <h3>Objectives</h3> To compare the sensitivity and specificity of various SLE classification criteria among multiracial Malaysians. <h3>Methods</h3> A retrospective study on data obtained from medical records of SLE and control cases. The sensitivity and specificity of 1997 American College of Rheumatology (ACR) revised criteria, Boston Weighted (BW) criteria, 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria, and 2019 European League Against Rheumatism (EULAR)/ACR classification criteria was calculated at baseline and at one year follow up. The link of diagnostic criteria to disease outcomes five years after diagnosis [disease damage, cardiovascular (CV) outcomes, and mortality] was studied. <h3>Results</h3> 420 SLE cases and 420 control cases were recruited. At baseline, the sensitivity and specificity of 1997 ACR criteria, BW criteria, 2012 SLICC criteria, and 2019 EULAR/ACR classification criteria were 69.3% and 99.3%, 89.5% and 96.7%, 94% and 97,6%, 96.4% and 96.5%, respectively. At one year follow up, sensitivity and specificity of the1997 ACR criteria, BW criteria, 2012 SLICC criteria, and 2019 EULAR/ACR classification criteria improved to 72.9% and 99.3%, 91.4% and 96.7%, 97.1% and 97,6%, 100% and 96.9%, respectively. There is statistical correlation between the 2019 EULAR/ACR classification criteria and SLICC/ACR damage index (DI), and disease relapses. <h3>Conclusion</h3> 2019 EULAR/ACR classification criteria demonstrated the highest sensitivity to diagnose SLE, with comparable specificity to other diagnostic criteria. <h3>References</h3> [1]Bengtsson AA, Rönnblom L. Systemic lupus erythematosus: still a challenge for physicians. J Intern Med 2017;281:52-64. [2]Wang F, Wang CL, Tan CT, Manivasagar M. Systemic lupus erythematosus in Malaysia: a study of 539 patients and comparison of prevalence and disease expression in different racial and gender groups. Lupus 1997;6:248-53. [3]Bakula M, Čikeš N, Anić B. Validation of the new classification criteria for systemic lupus erythematosus on a patient cohort from a national referral center: a retrospective study. Croat Med J 2019;60:333-44. <h3>Acknowledgements</h3> Faculty of Medicine UKM and Research Ethics Committee UKM. <h3>Disclosure of Interests</h3> Mohd Shahrir Mohamed Said Speakers bureau: Novartis, Pfizer, Abbvie, Zuellig Pharma, Seow Chu Ee: None declared, Ruslinda Mustafa: None declared.
POS1449 CARDIOVASCULAR DISEASE IN PRIMARY SJÖGREN SYNDROME
Authors: C. L. Zippel, S. Beider, E. Kramer, F. F. Konen, T. Seeliger, T. Skripuletz, S. Hirsch, A. Dopfer-Jablonka, T. Witte, K. Sonnenschein, D. Ernst
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Primary Sjögren's syndrome (pSS) is associated with an increased prevalence of traditional risk factors and cardiovascular diseases (CVDs). <h3>Objectives</h3> The study aimed to identify specific risk factors for CVD in pSS patients. <h3>Methods</h3> PSS patients with and without CVD were compared. All patients fulfilled the EULAR/ACR classification criteria. Patients with CVD presented at least one of the following manifestations: myocardial infarction, transient ischemic attacks, ischemic or hemorrhagic stroke, peripheral artery disease, coronary artery disease and carotid plaques. Data were collected by a standardized protocol and review of medical records. <h3>Results</h3> 61/312 (19.6%) pSS patients presented with CVD. Traditional risk factors such as hypertension, hypercholesterinemia and diabetes (p&lt;0.05), pSS manifestations, in particular vasculitis (p=0.033) and Raynaud's phenomenon (p=0.018) were associated with CVD. Among patients with ischemic events (28/312, 9%), particularly cerebrovascular disease (n=12/28, 42.9%), correlations with increased EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) (p=0.039) and EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) (p=0.048) were observed. Age at first cerebrovascular event was 55.2 [48.9 – 69.6] years. Multivariate analysis confirmed hypertension (odds ratio (OR) 3.7, 95% confidence interval (CI) 1.87–7.18, p&lt;0.001), hypercholesterinemia (OR 31 3.1, 95% CI 1.63–5.72, p&lt;0.001), male gender (OR 0.4, 95% CI 0.17–0.78, p=0.009), Raynaud's phenomenon (OR 2.5, 95% CI 1.28–4.82, p=0.007) and CNS involvement (OR 2.7, 95% CI 1.00–33 7.15, p=0.048) as independent CVD predictors. <h3>Conclusion</h3> Raynaud´s phenomenon as well as vasculitis and high ESSDAI have shown a significant association to CVD. PSS patients with cerebrovascular events were younger than expected. Knowledge about risk factors may help clinicians to identify pSS patients at risk for CVD. After diagnosis of pSS, patients should be screened for risk factors such as hypertension and receive appropriate therapy to prevent or at least reduce sequelae such as infarction. However, further investigations are necessary in order to achieve a reliable risk stratification for these patients. <h3>Acknowledgements</h3> We would like to express our gratitude to the staff of the Rheumatology Outpatients Department at Hannover Medical School for their continual help in organization of patients Reference styles. <h3>Disclosure of Interests</h3> None Declared.
AB0642 ANTI-SSA POSITIVITY AND SALIVARY GLAND ULTRASOUND AS SCREENING TOOLS FOR PRIMARY SJÖGREN’S SYNDROME IN PATIENTS WITH SICCA SYMPTOMS
Authors: K. Chandwar, D. P. Misra, K. Kishor, P. Dogga, A. Wakhlu, V. Agarwal, A. Wakhlu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Salivary Gland ultrasound is a sensitive point of care investigation for the assessment of salivary gland dysfunction. It can be abnormal in patients with primary Sjögren's syndrome(pSS), Sarcoidosis, IgG4 disease, Systemic sclerosis, Infections and Tumors. <h3>Objectives</h3> To understand the utility of Anti-SSA, ANA and Anti-SSA/SSB and Salivary gland ultrasound for diagnosing primary Sjögren's Syndrome in patients with Sicca symptoms. <h3>Methods</h3> In the current study, In patients referred to the department of Clinical Immunology and Rheumatology, King George's Medical University, with Sicca Symptoms, a salivary Gland Ultrasound was performed and in those with abnormal ultrasound (Hocevar Score ≥1) Clinical and serological evaluation were performed. The Sensitivity and Specificity of Salivary Gland ultrasound with a Hocevar score ≥17 to diagnose primary Sjögren's Syndrome was assessed, and the utility of ANA, Anti-SSA and Anti-SSB positivity in patients with abnormal ultrasound was assessed. <h3>Results</h3> A total of 78 patients with sicca symptoms and abnormal salivary gland ultrasound (Hocevar Score ≥1) were included of these, 36 were diagnosed with primary Sjögren's syndrome and 42 with other diseases, including 12 with Rheumatoid arthritis, 8 with Systemic lupus erythematosus, 7 with systemic sclerosis, 4 with IgG4 related disease and 4 with Sarcoidosis. 7 patients did not have any autoimmune rheumatic disease after evaluation. The mean age of pSS patients was 36.42 ±11.68 and for non-pSS patients was 44.45 ±15.31. A Hocevar score ≥17 has a sensitivity and specificity of 80.56% and 78.57%, respectively. Adding ANA to the screening protocol improved the sensitivity but reduced the specificity while adding Anti-SSA to the screening protocol improved sensitivity, specificity, positive likelihood ration, accuracy and area under curve for diagnosing pSS. <h3>Conclusion</h3> Anti-SSA positivity and abnormal salivary gland ultrasound in patients with Sicca symptoms can be effective screening tools for diagnosis primary Sjögren's Syndrome. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.